The two objections raised to this amputation are:—
1. That it is impossible to fit a wooden bucket because the bone at the lower end of the stump is larger than it is at a higher level.
2. That it does not leave enough room to fit an artificial knee joint at the right level.
These two objections are not valid, and, on the other hand, this amputation allows us to fit an artificial limb with complete end bearing, and this is a great advantage.
1. Fitting of the bucket.—The first difficulty is easily got over. All that is necessary is to cut away the front of the lower half of the bucket, and to cover in this opening with a lacing piece of leather. The stump passes into the top of the bucket, comes out of this opening and then falls back into the enlarged lower end where it takes a direct bearing (Fig. 99).
Fig. 99.—Limb with end bearing for amputation in the region of the condyles of the femur. Anterior part of the thigh bucket cut away to allow the insertion of the enlarged lower end of the stump.
2. Level of the knee joint.—It is clear that if the stump is too long it is impossible to fit a knee joint with a bolt right through at the same level as the opposite knee. The thigh piece would have to be prolonged downwards in order to allow of the insertion of this bolt.
This arrangement would not affect walking, but would be unsightly in sitting because of the inequality in the length of the thighs.